In recent year, non-intubated anesthesia had emerged as an available alternative for thoracic procedure. Whether non-intubated tracheal/carinal reconstruction confers distinct perioperative advantages over the conventional intubated approach remains uncertain. The purpose of this study was to evaluate the safety and perioperative outcomes of non-intubated versus intubated approaches in tracheal and carinal reconstruction.
Tracheal/carinal resection and reconstruction remains a technically demanding procedure with high risks of morbidity and mortality. Traditionally, tracheal surgery is performed under intubated anesthesia, with intermittent endotracheal ventilation to maintain oxygenation during airway reconstruction. However, endotracheal intubation with cross-field ventilation obstructs the surgical field and potentially complicating the reconstruction procedure. Non-intubated anesthesia have has gained widespread adoption for modern thoracic surgery. However, the safety and feasibility of non-intubated tracheal and carinal reconstruction have not been studied by randomized controlled trial. So, this randomized controlled trial aims to evaluate whether the non-intubated approach offers comparable short-term and long-term outcomes to the conventional intubated procedure.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
176
non-intubated tracheal and carinal reconstruction
intubated tracheal and carinal reconstruction
the First Affiliated Hospital of Guangzhou Medical University
Guangdong, Gaungzhou, China
RECRUITINGConversion rate
The rate of conversion to intubated approach in the operation
Time frame: postoperative in-hospital stay up to 30 days
Postoperative complications rate
Number and severity of adverse events that are related to the treatment of each patient. Postoperative treatment-related complications were assessed by the Clavien-Dindo Classification. Treatment-related adverse events as assessed by CTCAE v5.0.
Time frame: postoperative in-hospital stay up to 30 days
Operative time
Operative time was defined as the time between the start of the surgery (incision) and the finish of surgery (closure of the skin).
Time frame: postoperative in-hospital stay up to 30 days
Length of stay (LOS)
Length of stay is the duration for enrolled patients until the date of meeting the criteria of hospital discharge since the date of surgery.
Time frame: postoperative in-hospital stay up to 30 days
Postoperative ICU stay
Postoperative hospital stay is the duration for each patients until the date of meeting the criteria of ICU discharge since the date of surgery.
Time frame: postoperative in-hospital stay up to 30 days
Intraoperative bleeding loss
blood loss in the operation
Time frame: postoperative in-hospital stay up to 30 days
Length of resection
Length of resection in the operation
Time frame: postoperative in-hospital stay up to 30 days
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Reconstruction time
Reconstruction time was defined as the time between the start of resection (tracheal) and the finish of reconstruction (tracheal).
Time frame: postoperative in-hospital stay up to 30 days
Volume of postoperative drainage
The volume of postoperative drainage of the patient was the sum of his daily drainage volume after the surgery.
Time frame: postoperative in-hospital stay up to 30 days
1-year disease-free survival (DFS)
DFS at 1 year after surgery
Time frame: 1 year after surgery
1-year overall survival(OS)
OS after surgery
Time frame: 1 year after surgery